Related Experiment Video
Updated: Nov 11, 2025
Postoperative Ileus Murine Model
Published on: July 12, 2024
Risk factors for postoperative ileus following loop ileostomy closure
Aydın Aktaş1, Cüneyt Kayaalp2, Mustafa Ateş3
1Department of General Surgery, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
Insights
Loop ileostomy closure (LIC) can lead to postoperative ileus (POI). An open surgical technique during initial surgery and hand-sewn anastomosis during LIC are identified as key risk factors for developing POI.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Postoperative ileus (POI) is a frequent complication after loop ileostomy closure (LIC).
- Identifying risk factors for POI is crucial for improving patient outcomes and developing preventive strategies.
Purpose of the Study:
- To investigate the risk factors associated with the development of POI following loop ileostomy closure.
- To provide recommendations for the prevention of POI after LIC.
Main Methods:
- Retrospective analysis of patients undergoing LIC with peristomal incision after distal colorectal surgery.
- Evaluation of complications including POI, surgical site infection (SSI), bleeding, and anastomosis leakage using standardized criteria.
- Univariate and independent variable analysis to identify significant risk factors for POI.
Main Results:
- POI developed in 9 out of 79 patients.
- Univariate analysis identified age <60, comorbidities, open technique in primary surgery, total colectomy, hand-sewn anastomosis in LIC, and blood transfusion as risk factors for POI.
- Independent risk factors for POI were hand-sewn anastomosis during LIC and open technique in the initial surgery.
Conclusions:
- The use of an open technique during the initial surgery and a hand-sewn anastomosis during loop ileostomy closure are associated with an increased risk of postoperative ileus.
- These findings suggest modifications in surgical approach may help reduce POI incidence.
Objectives:
The most common intra-abdominal complication following loop ileostomy closure (LIC) is postoperative ileus (POI). The aim of the study was to determine the risk factors of POI development following LIC and make recommendations for its prevention.
Material And Methods:
In this study, patients having undergone LIC with peristomal incision following distal colorectal surgery were included. Clavien-Dindo classification was used to evaluate postoperative complications. POI and postoperative leakage were defined based on clinical and radiological criteria. The Centers for Disease Control and Prevention 2017 criteria were used to diagnose surgical site infection (SSI). Postoperative bleeding was diagnosed one day after surgery if there was a >2 g/dL or ≥15% decrease in the hemoglobin level.
Results:
Seventy-nine patients were included into the study. In nine of the patients POI developed, six had SSI, five had postoperative bleeding, and two had anastomosis leakage. In the univariate analysis; age <60 years (p= 0.02), presence of comorbidity (p= 0.007), using an open technique in the first surgery (p= 0.02), performing total colectomy in the first surgery (p= 0.048), performing hand-sewn anastomosis of LIC (p= 0.01), and postoperative blood transfusion (p= 0.04) were found to be risk factors for POI. Performing hand-sewn anastomosis of LIC (p= 0.03) and using an open technique in the first surgery (p= 0.03) were found to be independent variables for POI risk.
Conclusion:
Using an open technique in the first surgery and performing a hand-sewn anastomosis of LIC may increase POI.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:24Ostomy Care
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies: